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心电图 V_1导联出现一种异常 P 波终末向量(简称 PTFv_1)的概念,是由 Morris 等首先提出,并应用于心脏瓣膜病的研究。他指出 PTFv_1负值异常与左心房的肥厚和扩张有关。随后研究发现,不少心脏疾病都会出现 PTFv_1负值的变化。近年来,国内外对心电图 PTFv_1的测量日趋增多。许多文献资料指出,PTFv_1负值异常在某些心脏病诊断中有重要意义。为了进一步认识心电图 PTFv_1的产生机理,掌握正常值限,探讨其在不同类型疾病中的诊断价值,现将有关心电图PTFv_1的资料综述如下。Morris 认为左心受累时,左心房在横面的向量轻度向右旋转,以及左房传导延迟或传导途径延长。这些变化可能作为引起心电图 P 波变化的病理基础而单独或同时存在。心房除极,产生 P 波。在正常情况下,心脏的激动发源于位于右心外膜,上腔静脉入口的“窦房结”。藉3支含有浦肯野氏纤维的结间束(前、
The concept of an abnormal P-wave terminal vector (PTFv_1) appears in the ECG V_1 lead, first proposed by Morris et al and used in the study of valvular heart disease. He pointed out that negative PTFv_1 abnormalities are associated with left atrial hypertrophy and dilation. Subsequent study found that many heart diseases occur PTFv_1 negative changes. In recent years, the measurement of electrocardiogram PTFv_1 has been increasing at home and abroad. Many literatures point out that the negative PTFv_1 value is of great significance in the diagnosis of some heart diseases. In order to further understand the mechanism of electrocardiogram PTFv_1, to grasp the normal limit, to explore its diagnostic value in different types of diseases, the information on the ECG PTFv_1 are summarized below. When Morris thought left-sided involvement, the vector of the left atrium on the transverse plane rotated mildly to the right, and the left atrial conduction delay or conduction route was prolonged. These changes may act as a pathological basis for P wave changes in the ECG, either alone or in combination. Atrial depolarization, resulting in P wave. Under normal circumstances, the heart of the excitement originated in the right epicardium, superior vena cava entrance “sinus node.” By 3 containing Purkinje fibers between the bundle (before,